addiction Flashcards by brooke posey

using meds for different reasons than accepted purpose

substance abuse

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negative physiologic, physical and psychological reactions; craving for drugs when stopped

Withdrawal

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need of drug to avoid withdrawal symptoms

chemical dependence

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drug-seeking behaviors; interference with life, relations, and work

addiction

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reduction in drug’s effect via persistent use; demands increased dosage

tolerance

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use of a substance resulting in maladaptive behavior

intoxication

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process of safely withdrawing from a substance

Detoxification

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problems associated with addiction tolerance, withdrawal, attempts to stop

substance dependence

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continues to function without conscious awareness or memory of actions

blackout episode

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after continued heavy drinking, only small amounts can cause intoxication

tolerance break

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natural recovery

Spontaneous Remission:

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What are the psychologic factors of substance abuse?

People use alcohol as a coping mechanism or to relieve stress and tension, increase feelings of power & decrease psychologic pain.

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What are the social & environmental factors of substance abuse?

Influence include cultural, social & availability attitudes, peer behaviors, laws
-Many people view the social use of cannabis, although illegal, as not very harmful.

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What are the cultural considerations of substance abuse?

Muslims do not drink alcohol
Native American & Alaska Natives, fifth leading case of death(motor vehicle crashes, alcoholism, cirrhosis, suicide & homicide).
Male Russian have high rated of alcohol abuse, suicide, Smoking, accidents, violence, & cardiovascular disease

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Cultural considerations of alcohol

Muslims: no alcohol
Jewish: wine an integral part of religious rites
Some Native American tribes: peyote (hallucinogen)
Japanese: alcohol not a drug

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What are the categories of drugs?

Alcohol
Sedatives, hypnotics, and anxiolytics
Stimulants
Cannabis
Opioids
Hallucinogens
Inhalants

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considered legally intoxicated for adults operating automobiles

A laboratory blood alcohol concentration(BAC) of 0.08%

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Effects of alcohol?

CNS depressant: relaxation/loss of inhibition
Effects of excess: Slurred speech, nystagmus, memory loss, vomiting, decrease level of consciousness( stupor or coma, hypotension, respiratory arrest, peripheral collapse, & death

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Chronic alcohol dependence can lead to?

Direct cardiovascular damage, liver damage (ranging from fatty liver to cirrohosis) erosive gastritis & gastointestinal bleeding, acute pancreatitis , sexual dysfunction.

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what is the cycle of alcoholism?

1st episode of intoxication—continuing problems with alcohol-first blackout-continued drinking-development of tolerance-tolerance break-continued drinking-functioning becoming affected-periods of abstinence/temporary controlled drinking-escalatin of alcohol intake-more problems-subsequent crises-continuation of cycle

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When does withdrawal start to occur?

Onset within 4 to 12 hours after cessation or marked reduction of alcohol intake (see Box 19.2); peaking on second day; complete in about 5 days

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What are the s/s of withdrawal?

abdominal cramping; vomiting; tremors; restlessness & inability to sleep; increase heart rate; transient hallucinations or illusions; anxiety; increase blood pressure, respiratory, respiratory rate & temperature; & tonic- clonic seizures

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What are some benzodiazepines for safe withdrawal?

Chlordiazepoxide (Librium), Diazepam(Valium) or Lorazepam (Ativan)

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What are the complications of alcohol dependence?

impaired memory, CVA, metabolic deficiencies, cardiomyopathy, neurologic disorders, fetal alcohol syndrome

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Congestion & venous pathway through increased fluid pressure in the venous pathway through the liver. Signs& symptoms-GI bleed, ascites, encephalopathy, decreased platelets

portal hypertension

dilated, bulging esophageal veins

Esophageal Varices

Alcohol dependence medical management and rehabilitation includes?

* detoxification * nutritional therapy * psychotherapy * drug therapy * support groups

drug therapy for alcohol dependence includes?

aversion therapy—Disulfiram(Antabuse)

Help’s the patient | cravings for alcohol& decrease the physical & emotional discomfort that occurs first few months

Acamprostate (Campral

alone, with oral overdose rarely fatal; lethargy, confusion

Benzodiazepines ( i.e. Diazepam)

overdose possibly lethal; coma, respiratory arrest, cardiac failure, death; lavage, charcoal and saline cathartic, dialysis

Barbiturate(i.e.Pentobarbital)

cns depressants effects of intoxication

Increased drowsiness & sedation, agitation, slurred speech, uncoordinated motor activity, nystagmus, disorientation, nausea, vomiting, respiratory depression

cns deprssants withdrawal manifestations?

Anxiety, insomnia, diaphoresis, hypertension, possible psychotic reactions, hand tremors, nausea, vomiting, hallucinations, psychomotor agitation, seizure

essential in barbiturates to prevent coma or death

Detoxification via drug tapering

stimulate or excite CNS

cns stimulants

can cause brain damage due to agricultural fertilizer or substances used to make it

Methamphetamine

mild effects of cns stimulants

dizziness, irritability, tremor, blurred vision

severe effects of cns stimulants

hallucinations, seizures, extreme fever, tachycardia, hypertension, possible cardiovascular collapse & death

examples of cns stimulants

amphetamines and cocaine

dysphoria, fatigue, vivid and unpleasant dreams, insomnia or hypersomnia, increased appetite, psychomotor retardation or agitation, depressive symptoms, including suicidal ideation for several days

Withdrawal syndrome

treatment for withdrawal syndrome of cns stimulants?

chlorpromazine (Thorazine)-

antipsychotic controls hallucinations, lowers Bp and relieves nausea

chlorpromazine (Thorazine)-

Onset of withdrawal within hours to several days Dysphoria, fatigue, unpleasant dreams, insomnia, hyperactivity, increased appetite, psychomotor retardation and agitation Marked withdrawal- crashing; not treated pharmacologically

CNS stimulants | Withdrawal and Detoxification

Central nervous system (CNS) stimulants: produce extreme pleasure, euphoria, stimulation, increased energy

Cocaine and Methamphetamine Dependence

powder; dissolved; injected

cocaine

purified form of cocaine; mixed with tobacco, marijuana; freebased

crack

combining OTC meds, chemicals; smoked or IV injection

Methamphetamines

effects of intoxication of Cocaine and Methamphetamine Dependence

Mild(dizziness, irritability, tremor, blurred vision :Severe (hallucinations, chest pain, possible cardiovascular collapse & death)

complications of long-term abusers of cocaine and methamphetamines

Anorexia; memory impairment; weight loss, behavioral changes, paranoia, and hallucinations HTN, seizures, cerebral hemorrhage, MI, respiratory arrest, cocaine bugs;

added risks for methamphetamines include?

contracting HIV, hepatitis B

Medical Management and Rehabilitation for Cocaine and Methamphetamine Dependence

Referral to Cocaine Anonymous; group psychotherapy | Medications: increase, mimic effects of dopamine; antidepressants: relieve dysphoria; amino acid precursors

Excessive use and effects of intoxication of marijuana

Excessive use possibly leads to delirium or cannabis-induced psychotic disorder Effects of intoxification: ling cancer, chronic bronchitis, increased appetite, dry mouth, tachycardia

defined as an increase in need of opioid dosage to obtain optimum pain relief

opioid dependence

results in increased consumption of opioids to maintain euphoric and erratic mood

opioid addiction

What is The Pasero Opioid- Inducted Sedation Scale

``` S = sleep, easy to arouse; no action necessary 1 = awake and alert; no action necessary 2= occasionally drowsy but easy to arouse; require no action 3 = frequently drowsy and drifts off to sleep during conversation; decrease he opioid dose 4 = somnolent with minimal or no response to stimuli; discontinue the opioid and consider use of naloxone ```

What is the opiate dependence medical management and rehabilitation?

clonidine and methadone

Reality Intended affect: Heightened sense of self & altered perceptions(colors being more vivid while under the influence)

hallucinogens

examples of hallucinogens

ecstasy, PCP, LSD, mescaline

Intoxication from a soaked rag with the compound, from a paper or plastic bag, or directly from the container Can cause significant brain damage, peripheral nervous system damage, & liver disease

inhalants

Patient can suffer from persistent dementia, psychosis, anxiety,

inhalants

effects of intoxication of nicotine?

increased carbon monoxide blood levels; gastric ulcers; peripheral blood vessel constriction ; overstretched, inelastic alveoli

What is the pharmacologic therapy for nicotine?

Bupropion, Varenicline

substance abuse treatment for alcoholics

Disulfiram (Antabuse) may help deter drinking; Zofran for young males.

reduce cravings and decrease physical and emotional symptoms

Acamprosate (Campral)

used to treat heroin

Methadone , Buprenorphine/ naloxone, Clonidine, or Levomethadyl